#6 WEEK 10-11 - Achilles Tendon Rupture (ATR) - Non Surgical Treatment 

Glad to hear and wishing you speedy recovery!

Anthony Adams You're just saying that because she's hot. Lol

Awesome news Daryle! Keep at it, it gets easier with time. :) And thank you. :)

Your welcome. :) Your limp should improve as you strengthen your calf in physio, Claud. Try to walk from heel to toe and push off at the end of the step and it will get better with time. You can ask you physio to look at your walk and give you comments on small improvements you can make. My therapist recorded my walk and analyzed it for me in slow motion. That was very helpful in getting rid of the limp. Good luck and hope you next stage of healing goes well!

Thank you Agnes, some of the limping is down to nervousness but I know this will pass. I will keep on doing the exercises. Thanks for your encouragement. God bless :)

Hi Douglas, I am glad your recovery is going well. I never got around to editing and adding video from weeks 8 and 9. I did have a blog post with photos of progress and exercises I was doing at that time. You can find it at: achillesblog.com/agnesatr/2016/08/16/week-8-9/ Wishing you continuous successful recovery!

Douglas Landles Im on week 7 too. How does it feel walking in a boot? Do you use crutches to walk? Did you get surgery?

Hi Daryle, I got the following bike: www.amazon.com/gp/product/B007595TKU/ref=oh_aui_search_detailpage?ie=UTF8&psc=1 It has been great so far. I use it almost daily since week 6 of the injury (initially was using it while still in the boot). When I started biking with no boot I was told to keep my toes in injured leg pointing down when biking to avoid going into dorsi flexion and thus stretching the achilles. Basically needed to be cautious and stay in plantar flexion. I definitely highly recommend stationary bike as exercise. I still use it in month 7 and can see using it in winter months in the future as well, so it is worthwhile investment not just for this injury. :) And one day at the time is definitely the right attitude! It's such a long recovery process, so it's important to enjoy every milestone and keep positive. Keeping fingers crossed for your successful first steps in 2 shoes! That is a very exciting milestone. :)

Sorry about your rupture and yep, it is one annoying injury, but hang in there it will get better with time and work. As far as discomfort when getting out of the boot - yes, it is normal, as your muscles are re-learning to be used again, you do not have dorsiflexion flexibility and your calf muscle atrophied probably. Few things that helped me: - inserts that I wore in my shoes to reduce the dorsiflexion (you wear them in both shoes) - this will help with tightness and was probably the biggest help with discomfort. (pics: achillesblog.com/agnesatr/2016/10/13/wk-14-18/) - wearing a compression sock - kt tape - my pt showed me how to tape up (pics: achillesblog.com/agnesatr/2016/09/02/week-10-11/) - self massaging upper calf muscles few times a day - doing PT exercises given to me at that time of recovery (increases circulation in that leg) Good luck with your walking!

You are a wonderful human being, thank you for all this information, your blog is a gold mine. I will keep on working on my leg and as you said progress cannot be made without challenges. Thank you so much again!

James Ricci I am in week 8 of a full rupture, non operative treatment 52 years old. Must admit I'm surprised by the length of time you're expected to be in a cast. I was in a cast for two weeks and went to the boot and have actually been walking without any assistance since week 7. Actually did the gardening this weekend in shoes. These days it seems they want you to weight bear asap for quicker recovery. Good luck. The biggest thing for me was to keep up with any exercise you can

Yes. I agree it does seem bit long. I was in a boot the first 3 days. Must've been something in the MRI? How much of a rupture was yours? Mine was less than 50%. IS this what they call healing long? Short? Thanks and happy you are progressing fast. Keep me updated. @@andrewtremelling4777

how' s it going so far im in the 2 month

I’m on week 7 how is your healing

How is your recovery?

@@zakariamaster7717 salam Zakaria cv . wach déjà rupturé Khouya. ana f semaine 5 platre 90 degree. kiwaliti daba . ollah ychafi ljami3

Hi SJ, Yep I did feel the stretch while walking due to delayed stretching. I was asked to initially put heel pads in my shoes. I also got these sports shoes with raised heels and added additional heel lifts in them. That helped a lot. I have a pic of the heel lifts here: achillesblog.com/agnesatr/2016/10/13/wk-14-18/ I was able to put the lifts in my hiking boots too and when I was transitioning to hill walking that was helping with not yet stretched out achilles. I was also told that the stretch you feel while walking is a dynamic stretch and ok at that stage. It does not do the same as actively stretching the achilles for 30sec-1min while doing PT. The lifts were recommended to reduce discomfort before flexibility was regained. Initially I was going on stairs one foot at the time. Not very enjoyable. Searching my blog it showed up that I got positive Thompson test at week 14: achillesblog.com/agnesatr/2016/09/15/wk-12-13/ Hope you are continuing heal well!

Thanks Agnes. Unfortunately I've faced a slight setback because the outside of my ankle has started hurting a lot which is preventing me from staying in the neutral boot position. I've had to add a 1cm wedge back in to alleviate the pain. My physio thinks its peroneal tendonitis but I'll see what the doc says tomorrow. I noticed you also got a fair bit of pain that led you putting in a wedge into your sneakers. Was it directly under the heel or was your pain on the outside of the ankle like mine? How did you get rid of your pain? Did it just disappear over time or did you target exercises for it? Thanks again for your time!

Mine was directly under the heel. That was helped with silicon pads in the boot and then shoes. Calf massage helped for it too. Then I had some pain in the tendon and that was remedied with the higher heel inserts. That was due to lack of flexibility. We backed off on some of the exercises when the pain persisted. From what I have seen in my case and in others - everyone had some pains and aches along the way that kept popping up. In my case my pt was excellent in adding exercises specifically addressing my pains and also manually treating them in the office. Just remember it is normal to see these, but make sure your doc and pt address them and help you fix them.

Chris, for sure, getting into shoes is a process. I had a philosophy of "better safe than sorry" at that stage. Just did not want to do something to re-rupture and start the process all over again. I was initially only walking in the shoes in the house, then small outings outdoors that were shorter and safe. Other than that, boot was back on. It was all gradual. Boot always went with me in the car, in case I needed it. Any more strenuous activities or something on uneven surface and I would put the boot on. I was also slowly stopping sleeping with the boot at that time. I wrote a bit about these here: achillesblog.com/agnesatr/2016/09/02/week-10-11/ I am 2 days from 1 year and have been close to 100% for 3 months or so. I do not think about achilles much now, but maintain the calf raises and am much better about warm ups. So, thankfully it worked out for me. Good luck with walking in the shoes. Definitely an exciting stage, but be careful, that's when you need to be more cautious with all the uneven surfaces!

Javir, I did my first single calf raises at week 17. Here is the vid of starting of single calf raises: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-5IKHuKS_g9I.html and notes about it: achillesblog.com/agnesatr/2016/10/13/wk-14-18/ My physical therapist started me on double calf raises in week 10. They were with a foam roller/towel under my heels initially: achillesblog.com/agnesatr/2016/09/02/week-10-11/ and I progressed to flat floor calf raises over the following 5 weeks or so. The under heel raise is only not to overstretch the achilles too soon. Other than that I am only using fingers to touch the wall for balance.

Agnes S: Thank you very much for your reply.

Here is the boot I used: achillesblog.com/agnesatr/atr-equipment/ Then at the end of week 9 I was put into Aircast boot. You can see it here: achillesblog.com/agnesatr/2016/09/02/week-10-11/ The boot is something to get used to, but I have to say I was never really uncomfortable, so maybe you need a different size? Good luck with your recovery!

Agnes do you have the name because my boot looks the same but is heavier

I included the label the boot came in in the first pic, so all the info is there.

daryle523 - Sorry to hear about your issues with potential miscommunication between your doc/PT. In my case, I saw my doc every time there needed to be change in the angle of my foot and when I needed to start partial weight bearing. That was not up to PT it was up to my doctor. Doc followed the protocol, but also did not leave me with only a printout, but wanted me in the office to examine me before going to the next stage of the protocol. I chose do to my PT in the same clinic, where my doctor is located, so all my information is in the same system for the doctor and PT and they know each other as well. I know the communication would not be as good if PT was not in the same clinic. I had also memorized my protocol from the print out I was given and always questioned my doc and PT about different stages. I guess you can have a conversation with your PT about the details of the protocol you were given in the printout and ask for the PT to go over details, so that you also can monitor the progress appropriately and question him/her! I am sorry you had to deal with this miscommunication, but hopefully after your doc's email things will get straightened out. As far as swelling, yep - that is normal once you start walking. Compression socks were very helpful for that. My PT recommended that. The tape was only for mental reminder not to take bigger steps. That's all. It does not protect really against reruptures.

Hi Robert, sorry about your second rupture... My achilles is fully recovered and my recovery was pretty straight forward. It was not easy, but I did not have major set backs. I did, however, put a LOT of work into it to get back to normal. Saying that, I was a good candidate for non-op, so just make sure that is the case for you. Ask your doctor to do imaging of your leg to determine your gap size and to make sure that the rupture is straight forward (no bone spurs, no bone injury and that tendon ends meet when your foot is plantar flexed). Also, if you decide to go non-op, just make sure you choose a doctor and physical therapist that know how to treat non-op. The initial protocol for op and non-op are different. The stretching time line is different as well. For non-op the initial weeks plantar flexion is most important to reduce scar tissue creation between the tendon ends. As far as protocol, I know that there are many, but from the newer studies it shows that early weight bearing and early mobilization is the most effective form of treatment at the moment. Good luck with your decision. I know it is not easy...

Dear Agnes now I am the spiral, waiting for tomorrow morning when is going to happen my surgery, I think I have no other choice, to many opinions pro surgery.I am happy that you fell good.I watched all your videos , you did a greate job with it.you're strog and brave, I apriciate a lot yours perseverance. You give me motivation :)

Good luck with your surgery and wishing you smooth recovery and patience!

Agnes you have been my inspiration for the last 6 weeks I have finished week seven and am getting better thanks to you I tore a 2-3 mm tear playing tennis at 62 years of age Non surgical and at week 8 I will see my doc which is next week Still at 30 degrees and look forward to coming down to 15 degrees at eight weeks Feel good and ready for my PT input Patience has a new meaning Thanks for your inspiration Jimmy G

Glad the videos helped James. Good luck with the new stage of your recovery. Once the PT starts, it will be hard work, but it will also be more rewarding!